USMLE Step 2,3 Takers - Page 1

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Welcome! Here is a place for discussion ,solve the problems and preparing for usmle step 2,3 Aim high,Study hard,Live your dreams Contact:@ISAAC_AZAD or @usmlesteptakers
Is.A
2016-06-25 09:52:28
Cord Compression Look for back pain with: ·· Hyperreflexia ·· Vertebral tenderness ·· Weakness ·· Upgoing toes (extensor plantar reflex) ·· Sensory “level”: decrease in sensation below the point of compression.
Is.A
2016-06-25 09:52:28
Management of Cord Compression When these conditions are present, this is a super emergency. To avert paralysis, you must: 1. Give 10 mg IV bolus of dexamethasone to reduce pressure/ swelling on the spinal cord. 2. Get an MRI of the spine immediately. 3. Get an emergency neurology evaluation. 4. Evaluate for decompressive surgery.
Is.A
2016-06-25 09:52:28
Low back pain can be considered “benign” if: ·· No focal neurological deficits ·· No hyperreflexia ·· No spine tenderness An abnormal “straight leg raise” test on physical examination is not a “focal neurological deficit.” An abnormal straight leg raise is simply a radiculopathy or peripheral neuropathy of the nerve root.
Is.A
2016-06-25 09:52:28
Management of Benign Low Back Pain 1. NSAIDs (e.g., ibuprofen) 2. Stretching, yoga, chiropractic, acupuncture 3. Cyclobenzaprine, a muscle relaxant that can cause sleepiness
Is.A
2016-06-25 09:52:28
***Bed rest or an MRI is wrong for benign low back pain.
Is.A
2016-06-25 09:52:28
Hence, unless there are additional severe findings described in the case, the most likely answer is: • No x-rays • No bed rest • Yes to moderate exercise and stretching such as yoga Fever with signs of cord compression suggests a spinal epidural abscess.
Ahmad Al Tamimi
2016-06-25 11:22:00
Hey Guys, nice effort, this is Ahmad and I am planning to sit for Step3 in November.
Ahmad Al Tamimi
2016-06-25 11:22:23
Anyone on the same date?
Is.A
2016-06-25 13:20:18
1. Abdominal Aortic Aneurysm Screening: men ever smokers 65-75 men (1x only) 2. Alcohol misuse screen adults age 18 or older for misuse and provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse CAGE for 18+ if pos, provide counseling 3. Aspirin to prevent CV dz: men men 45-80 heart attack > GI bleed 4. Aspirin to prevent CV dz: women women 55-80 ischemic stroke > GI bleed 5. Bacteriuria screening in preggo women do it 12-16 weeks or first visit tx even if asymptomatic 6. Blood pressure screening in adults take bp if 18+ 7. BRCA risk assessment and genetic counseling screen pt for fam cancer hx of: -breast -ovarian -tubal -peritoneal if +, counsel 8. Breast cancer preventive meds offer tomoxifen or raloxifene (if increased risk) 9. breast cancer screening 40yo+ (poss 50; unclear) mammo q1-2yrs 10. breastfeeding do it 11. Pap 21-30 Pap q3yrs 30-65 Pap + HPV testing q5yrs 12. Chlamydia & Gonorrhea screening sexually active F <24yrs + ≥24yrs if risky 13. lipid screening 20 if incr risk of CAD, otherwise Men: 35+ Women: 45+
Is.A
2016-06-25 13:20:37
14. Colorectal cancer screening 50 - 74 years -Hemoccult q1yr -sigmoid q5 -colonoscopy q10y 15. Dental caries prevention tooth eruption - 5yrs -> fluoride varnish 1° teeth oral fluoride supplementation ≥ 6 months (if water is deficient) 16. Depression screening ≥12 (if dx, tx, and f/u systems are in place) 17. Diabetes screening overweight 40-70yo if +, recommend diet and phys activity counseling 18. Falls prevention in older adults ≥ 65 years w/ incr fall risk (or younger if same risk as 65yo) 1) exercise 2) phys therapy 3) vit D 19. Gestational diabetes mellitus screening @ 24 weeks of gestation. 20. Gonorrhea prophylactic medication: newborns topical Abx (erythromycin) for all newborns (gonococcal ophthalmia neonatorum) 21. Healthy diet and physical activity counseling if: fat + cardiovascular disease (CVD) risk factors counseling for: -diet -phys activity 22. Hearing loss screening: newborns Screen all newborns 23. New born screenings: 1) Hearing 2) Sickle cell (Hemoglobinopathies) 3) Hypothyroid 4) Phenylketonuria 24. Hepatitis B screening high risk adolescents/adults & reg pregnant women 25. Hepatitis C virus infection screening: adults high risk ppl OR born between 1945 and 1965.